A heart can be considered the center of a circulatory system within a body. For example, the heart can take deoxygenated blood from elsewhere in the body and provide it to the lungs to be oxygenated. The heart can then supply the oxygenated blood from the lungs to other parts of the body. In a healthy heart, each chamber can contract in a coordinated fashion, such as to provide adequate circulation of oxygenated blood and nutrients to sustain the body.
The heart can be affected by a variety of physical and electrical abnormalities. Physical abnormalities can include, among other things, enlarging of the heart, sometimes associated with ischemia. Electrical abnormalities can include, among other things, various arrhythmias, such as due to infarcts, congenital defects, aging, or one or more other factors. Certain arrhythmias can be life threatening, such as including a ventricular tachyarrhythmia or ventricular fibrillation. In some patients, such life threatening arrhythmias can be detected and terminated using low-energy electrical impulses, such as provided by an implantable pulse generator. Such low-energy electrical impulses can include anti-tachyarrhythmia pacing (ATP), but such pacing is not always indicated or effective for termination of a particular arrhythmia.
In cases where ATP is not indicated, or is ineffective, a defibrillation countershock can be provided, such as by an automatic implantable cardioverter defibrillator (AICD). An AICD can provide the defibrillation countershock subcutaneously, epicardially, or using one or more intravascularly-deliverable implantable leads such as located within or near the heart or vasculature.